医学
队列
动脉炎
危险系数
肺结核
入射(几何)
肺炎
死亡率
比例危险模型
内科学
流行病学
儿科
置信区间
病理
物理
光学
作者
Durga Prasanna Misra,Upendra Rathore,Swapnil S. Jagtap,Prabhaker Mishra,Darpan R Thakare,Kritika Singh,Tooba Qamar,D Singh,Juhi Dixit,Manas Ranjan Behera,Neeraj Jain,Manish Ora,Dharmendra Bhadauria,Sanjay Gambhir,Vikas Agarwal,Sudeep Kumar
标识
DOI:10.3899/jrheum.2023-1254
摘要
To describe the incidence, risk factors, and outcomes associated with serious infections in patients with Takayasu arteritis (TAK).Serious infections (defined as infections resulting in hospitalization or death or unusual infections like tuberculosis) were identified from a cohort of patients with TAK. Corticosteroids and disease-modifying anti-rheumatic drug (DMARD) use at the time of serious infection was noted. Demographic characteristics, clinical presentation, angiography, and disease activity at presentation and the use of DMARDs during follow-up were compared between patients with TAK with or without serious infections. Mortality in patients with TAK who developed serious infections was compared with those without was compared using hazard ratios (HR, with 95%CI).Of 238 patients with TAK, 38 (15.97%) had developed serious infections (50 episodes, multiple episodes in 8, three episodes resulted in death). Among the 38 initial episodes, 11/38 occurred in those not on corticosteroids and 14/38 in those not on DMARDs. Pneumonia (n=19) was the most common infection, followed by tuberculosis (n=12). Patients with TAK who developed serious infections vs those without had higher disease activity at presentation (active disease 97.37% vs 69.50%, ITAS2010 12.66±7.29 vs 10.16±7.02, DEI.TAK 11.21± 6.14 vs 8.76±6.07) and more frequently were initiated on corticosteroids or DMARDs. Hazard ratios calculated using exponential parametric regression survival-time model revealed increased mortality rate in patients with TAK who developed serious infections (HR 5.52, 95%CI 1.75-17.39).Serious infections, which occurred in the absence of immunosuppressive treatment in about one-fifth, were associated with increased mortality in patients with TAK.
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